What is Rosacea?

This week we discuss all things Rosacea, what it is, what the symptoms are and how you could potentially treat Rosacea.

One of the most common reasons patients will come in to speak with pharmacists is for skin conditions. This can vary from chicken pox, dry skin, eczema, to athletes' foot. However this week we are taking a look at Rosacea, which is probably one of those conditions that people have almost certainly heard of, but possibly don't know much about. Well sit tight, because in this week's article we take a look at what Rosacea is, what it feels like, and how you can help to treat it.

Rosacea is a common skin condition that causes blushing or flushing and visible blood vessels in your face. It may also produce small, pus-filled bumps. These signs and symptoms may flare up for weeks to months and then go away for a while. Rosacea can be mistaken for acne and other skin problems.

Rosacea can affect anyone. But it's most common in middle-aged white women. There's no cure for rosacea, but treatment can control and reduce the signs and symptoms.

What are The Syptoms of Rosacea?

Whilst several skin conditions have overlapping symptoms, rosacea is quite unique with its presenting symptoms.

• Visible veins - small blood vessels on your nose and cheeks become visible ( these are also known as spider veins)
• Swollen bumps - Many patients with rosacea develop pimples on the face that can be mistaken for acne, the pimples can also sometimes be filled with pus.
• Flushing of the face - Sometimes, rosacea can cause a permanent red flush across your cheeks - however it is more difficult to spot on brown and black skin.
• Sensitive skin - The skin of the affected area can become sensitive and tender to touch
• Eye problems - Many patients have reported issues with their eyes such as dry, swollen, itchy, and irritated eyes and eyelids. This can also be referred to as ocular rosacea.

What Causes Rosacea?

The exact cause of rosacea is unknown, but it could be due to an overactive immune system, heredity, environmental factors or a combination of these. It is important to note that rosacea is not caused by poor hygiene and thankfully it's not contagious.

Flare ups of the condition can be a result of:

• Hot drinks and spicy foods
• Red wine and other alcoholic beverages
• Temperature extremes
• Emotions
• Exercise
• Drugs that dilate blood vessels, including some blood pressure medications
• Some cosmetic skin or hair products.

Anyone can develop rosacea regardless of age or gender, however it is normally more prevalent in those that are over the age of 30, females, smokers, people with a family history of rosacea, and have skin that is more susceptible to burning in the sun.

How Do I Treat Rosacea?

Unfortunately, there is no cure for rosacea. However, there are a multitude of medicines that can help to relieve the symptoms of rosacea. As without treatment, the rosacea can be much more problematic. It is worth noting that a combination of medication and lifestyle changes generally tends to bring the most notable results.

Skin creams can help reduce inflammation and skin discoloration. Normally, your GP will prescribe them by using them once or twice per day. Examples include topical antibiotics such as metronidazole (Rozex 0.75% cream and gel), tretinoins, benzoyl peroxide (acnecide 5% gel), and azelaic acid (skinoren 20% cream). Common side effects of these topical creams include sensitive skin, dry skin, pruritis ( itchiness of the skin), erythema (redness of the skin), and skin irritation such as a burning or stinging sensation after applying it. For metronidazole, (Rozex) it is important not to drink whilst using this as it can make you violently sick.

Oral antibiotics can have anti-inflammatory effects. They tend to give faster results than topical ones. Examples include doxycycline, minocycline, and erythromycin. Tetracyclines are antibiotics that can help with eye symptoms. Doxycycline helps improve dryness, itching, blurred vision, and sensitivity to light in people with ocular rosacea.

If you have tried these medications and it is still not working, your GP may refer you on to a dermatologist for further investigation. Laser therapy can sometimes be a last resort if medication has not worked for you, however this is not normally available via the NHS.

For lifestyle changes, there are certain things you can try to stop and do more of to really reduce the symptoms of rosacea. For example, if you are aware of your trigger that can cause rosacea to flare up ie alcohol or spicy food, try to avoid this. 

• Wear a high SPF sunscreen of at least SPF30 every day
• Try to avoid heat, sunlight or humid conditions if possible
• Try to cover your face in cold weather
• Use gentle skincare products for sensitive skin

Alternatively, you may also want to reduce exposure to some commong triggers:

• Do not drink alcohol, if you do keep it to a minimum
• Avoid having hot drinks regularly
• Avoid consumption of high quantities of caffeine (found in tea, coffe and chocolate)
• Avoid cheese and spicy foods

If you feel like you could be suffering from rosacea, it might be worthwhile speaking to your local pharmacist or GP for some professional advice. They may initiate treatment for you and hopefully it sends you on your way to a much happier and healthier you.